ObjectiveTo evaluate the effect of smoking and drinking status on the prognosis of patients with esophageal squamous cell carcinoma (ESCC).MethodsThe clinical data of 483 patients with ESCC who underwent surgical treatment in Shannxi Provincial People's Hospital from 2007 to 2016 were retrospectively analyzed. Among them, 352 patients were male and 131 were female, with a median age of 64 (37-80) years. There were 311 smokers and 172 drinkers. The relationship between preoperative drinking or smoking status and the clinicopathological characteristics of patients with ESCC was analyzed. Log-rank method and Cox risk regression were used to conduct univariate and multivariate survival analysis, respectively.ResultsThe preoperative smoking status was related to the patient's tumor location (P=0.030). Drinking status was associated with tumor location (P=0.001), degree of differentiation (P=0.030), pathological T stage (P=0.024) and pathological N stage (P=0.029). Univariate survival analysis showed that smoking status did not affect the disease-free survival (DFS) (P=0.188) and overall survival (OS) (P=0.127) of patients with ESCC. However, patients who drank alcohol had worse PFS than non-drinking patients (29.37 months vs. 42.87 months, P=0.009). It was further proved that alcohol consumption was an independent risk factor affecting patients' recurrence and metastasis by using multivariate analysis (RR=1.28, P=0.040). Alcohol consumption also reduced the OS of patients by 21.47 months (P=0.014), however, multivariate analysis did not yield significant results.ConclusionPreoperative drinking status is related to the stage and differentiation of patients with ESCC. It is an independent risk factor affecting the recurrence and metastasis of ESCC.
Objective
To explore the status of smoking and passive smoking of the population with the high risk of stroke in the community and their attitude towards smoking control.
Methods
In March 2015, under the direction of Stroke Screening and Prevention Projection, the residents with the high risk of stroke were sought out in Longfeng Community, Suining City, Sichuan Province. And then their status of smoking and passive smoking and their attitude towards smoking control was investigated by Passive Smoking Questionnaire for Adults from National Smoking Control Office.
Results
A total of 354 residents with the high risk of stroke were sought out, in whom 152 (42.9%) were smokers, and the smoking rate of males (70.1%) and females (1.4%) was significantly different (P<0.001). Those aged 40-49 had the highest smoking rate (55.0%), followed by those aged 50-59 (51.7%), and smokers of the two age groups accounted for 73.0% of all smokers. There was significant difference in smoking rate among different age groups (P<0.001). The smoking rate of those with a lower education level of primary school (57.9%) was the highest, and there were significant differences in smoking rates among the population with different education levels (P<0.001). The smoking rate of the solitary (95.7%) was higher than that of the non solitary (34.9%) (P<0.001). In 202 non-smokers, 67 (33.2%) was suffered from passive smoking, and the rate of passive smoking was 31.3% in males and 62.3% in females with a significant difference (P<0.001). The proportion of the female non-smokers against passive smoking (84.1%) was higher than that of the male non-smokers (57.8%). According to the participants report, 79.9% of participants approved completely non-smoking in hospital, school and public transport, 66.4% approved non-smoking in the office and traffic station, and only 10.2% approved non-smoking in the restaurants.
Conclusions
The rates of smoking and passive smoking among the population with the high risk of stroke are high, and most of the population are supportive to smoke prohibition in public places except restaurants. The population with a low cultural level is short of smoking harm knowledge.
ObjectiveTo evaluate the effect of long-term systemic education management program on intervention of chronic obstructive pulmonary disease (COPD).
MethodsTwo hundred forty-six stable patients were interviewed face-to-face from March to August in 2013.They were divided into a systemic education group, a follow-up group and a control group according to different management program.The investigation contained general conditions, commonly used medicines, the effects of smoking cessation, the frequency of acute exacerbation in the year before investigation, COPD Assessment Test (CAT) and modified British Medical Research Council (mMRC).
ResultsThe success rate for smoking cessation in the systemic education group was 97.6%, which was higher than 81.0% in the follow-up group and 73.8% in the control group(P < 0.01).97.6% of patients in the systemic education group and 93.7% of patients in the follow-up group used bronchodilator.Whereas only 65.5% of patients in the control group inhaled bronchodilator, significantly lower than other two groups (P < 0.01).Mucolytic agents were taken by 14.5% and 19.0% of patients in the systemic education group and the follow-up group, and by 36.9% of patients in the control group (P < 0.01).The frequency of acute exacerbation was 0.9±0.9 both in the systemic education group and the follow-up group, which was lower than 1.2±1.0 in the control group (P < 0.05).CAT and mMRC in the systemic education group (10.2±5.7 and 1.5±1.0) and the follow-up group (11.1±5.8 and 1.5±0.9) were significantly lower than those in the control group (15.0±6.6 and 1.9±1.1, P < 0.01).
ConclusionsLong-term systemic education management program can improve success rate for smoking cessation and bronchodilator use, reduce the frequency of acute exacerbation, and improve quality of life effectively in COPD patients.
Objective To observe the levels of malonaldehyde (MDA) , interleukin-8 (IL-8) and tumor necrosis factor-α(TNF-α) in lung tissues of subjects with or without chronic obstructive pulmonary disease (COPD) , and investigate their roles in the the pathogenesis of COPD. Methods The content of MDA, IL-8 and TNF-αin lung tissues of smokers with COPD (n=9) , ex-smokers with COPD (n=8) , non-smokers with COPD (n=7) , healthy smokers (n=9) , healthy ex-smokers (n=8) and healthy nonsmokers (n=6) was measured with enzyme-linked immunosorbent assay ( ELISA) and corrected by creatinine. Results The levels of MDA, IL-8 and TNF-α in lung tissues of the COPD patients were significantly higher than those in the healthy subjects (Plt;0.05) , which were also significantly higher in the smokers when compared with the non-smokers (Plt;0.05) , whether suffering from COPD or not. In the COPD patients, not the levels of IL-8 but MDA and TNF-αin lung tissues of the smokers were significantly higher than those in the ex-smokers (Plt;0.05) ; whereas in the healthy cases, no statistical significance was revealed between the smokers and the ex-smokers on the levels of MDA and IL-8 in lung tissues except TNF-α( Pgt;0.05) . Conclusion The abnormal increase of MDA, IL-8 and TNF-αin lung tissues caused by chronic smoking may play an important role in the the pathogenesis of COPD.
ObjectiveTo investigate the effect of supervised smoking cessation program on COPD Assessment Test (CAT), modified British Medical Research Council (mMRC) and St George’s Respiratory Questionnaire (SGRQ) score and readmission risk in smoking patients with chronic obstructive pulmonary disease (COPD). Methods A total of 200 patients with COPD were enrolled in the study from the Department of Respiratory and Critical Care Medicine of Ganmei Hospital Affiliated to Kunming Medical University (The First People’s Hospital of Kunming) from April 2018 to December 2019. They were randomized divided into a control group (100 cases) and a supervision group (100 cases). The control group stopped smoking by their own will, and the supervision group was interfered on the basis of self-quit. Repeated measure analysis of variance was used to compare the CAT, mMRC, SGRQ scores and hospitalization times of the enrolled subjects before intervention, at the end of 6 months and 12 months of intervention, to evaluate the impact of supervised smoking cessation on the quality of life in smoking patients with COPD. Results CAT scores and mMRC scores were lower in the supervision group than in the control group after 6 months of follow-up compared with the baseline enrollment. There was a significant decrease in the supervision group, from 2.39 to 0.58 respectively; the decrease of control group was not obvious, from 0.15 to 0.01 respectively. After 12 months of follow-up, compared with enrollment and after 6 months of follow-up, the supervision group had a significant decrease, and the CAT score decreased from 4.45 to 2.06, respectively. The mMRC scores decreased by 1.03 and 0.45 points, respectively. The CAT scores of the control group were increased by 0.02 and 0.17 points, respectively, which showed an opposite trend to that of the supervision group. The mMRC score was decreased to a certain extent by 0.16 and 0.15 points, respectively, which was significantly less than that of the supervision group. The differences were statistically significant (P<0.05). After 1 year, compared with enrollment, the average SGRQ score decreased in both the supervision group and the control group. SGRQ symptom score decreased by 4.95 points and 3.51 points respectively; SGRQ activities decreased by 4.01 points and 10.00 points respectively; SGRQ effect score decreased by 5.33 points and 8.65 points respectively; SGRQ total scores were decreased by 6.26 points and 8.95 points respectively. And the number of cigarettes was reduced by 19.01 and 17.15 respectively. The differences were statistically significant (P<0.05). The decreasing range of CAT score, mMRC score, SGRQ symptom score and smoking counts in the supervision group was significantly higher than that in the control group. Considering the supervision to quit smoking can well reflect the improvement of clinical symptoms in COPD patients. In terms of the times of hospitalization, the risk of readmission was lower in the supervision group. Conclusions The mMRC, CAT and SGRQ scores showed that supervised smoking cessation could better improve the quality of life and reduce the risk of readmission in smoking patients. Lung function and quality of life were significantly better after intervention than before.
Objective To investigate the relationship between smoking and lung cancer by evidence-based evaluation. Methods Using Meta-analysis method, the results of 29 case-control studies involving the relationship between smoking and lung cancer in recent decade were analyzed by Review Manager 4. 2 software. Results The association between smoking and lung cancer was significant ( Z =12. 16, P lt; 0. 000 01) , and the pooled OR value was 5. 75( 4. 34, 7. 62) . The population attributable risk percentage( PARP) of smoking was 69. 16% . The pooled OR of 1-10 cpd( cigarettes per day) , 10-20 cpd, 20-40 cpd and more than 40 cpd were 1. 97( 1. 69, 2. 30) , 5. 20( 3. 54, 7. 62) , 7. 46( 5. 22, 10. 67) and 15. 14 ( 5. 27, 43. 44) respectively. The pooled OR of less than 20 years of smoking duration, 20-40 years and more than 40 years were 1. 25( 1. 01, 1. 53) , 5. 10( 3. 03, 8. 57) and 10. 77( 7. 30, 15. 89) respectively. While the pooled ORof less than 10 pack-years, 10-20 pack-years, 20-40 pack-years and more than 40 pack-years were 1. 73( 1. 01, 2. 96) , 3. 73 ( 3. 02, 4. 61) , 5. 69 ( 3. 79, 8. 54) and 8. 41 ( 4. 56, 15. 51) respectively. The pooled OR of initial smoking age less than 15 years old, 15-20 years old and more than 20 years old were 13. 31( 7. 09, 24. 97) , 7. 21( 4. 51, 11. 52) and 4. 74( 3. 47, 6. 47) respectively. The pooled OR of quitting smoking for 1-10 years, 10-20 years and more than 20 years were 7. 16( 4. 70, 10. 91) , 2. 12( 1. 16, 3. 86)and 1. 47 ( 0. 67, 3. 20 ) respectively, and more than 20 years of quitting smoking had no significant difference. The pooled OR of light smoking and deep smoking were 3. 26( 1. 24, 8. 58) and 8. 07( 4. 67, 13. 94) respectively. Conclusions Smoking is an important risk factor of lung cancer. Meta-anlalysis revealed cigarettes comsuption per day, smoking duration, total amount of cigarettes ( pack-years) , smoking behaviour( depth) , initial age of smoking and duration of quitting smoking can increase the risk of lung cancer.
ObjectiveTo systematically review the efficacy of exercise intervention on smoking cessation. MethodsCNKI, WanFang Data, VIP, Web of Science, PubMed and EMbase databases were electronically searched to collect randomized controlled trials (RCTs) and randomized cross controlled trials (RCDs) on exercise intervention for smoking cessation from inception to September 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Then, meta-analysis was performed using Stata 12.0 software. ResultsA total of 47 studies (35 RCTs and 12 RCDs) involving 5 130 subjects were included. The results of meta-analysis showed that acute exercise could significantly reduce the quitters’ desire to smoke (P<0.05), alleviate most of the withdrawal symptoms, and the effect of acute exercise was maintained for at least 30 minutes. Periodic exercise significantly reduced 7-day point abstinence and sustained abstinence rates in ex-smokers (P<0.05), and the effect of periodic exercise was maintained for at least 12 weeks, however, depression and stress were not found to be effectively relieved, and mood was not found to be significantly improved (P>0.05). ConclusionExercise intervention to quit smoking has a positive effect, however, more high-quality studies are needed to verify the above conclusion.
Objective To investigate the effects of smoking on β-defensin-2 ( BD-2) expression in induced sputumand lung tissue, and its role in chronic obstructive pulmonary disease ( COPD) . Methods Patients suffering with early peripheral squamous celled lung cancer and underwent lobectomy were divided into a smoking COPD group ( COPD group) , a non-COPD smoking group ( smoker group) , and a nonsmoking group ( control group) . Preoperative induced sputumsamples were collected after hypertonic saline induction. Lung tissue samples were intraoperatively collected far from the tumor site. The sputum samples were prepared for total and differential cell count, while the lung tissue samples for pathology examination. The BD-2 concentration in sputumand lung homogenate were measured by ELISA. Correlation were analyzed between BD-2 concentration and smoking index, airway inflammation, and lung function. Results The lung pathology were highly consistent with the experimental grouping. The total cell count and neutrophils proportion in sputum and BD-2 concentration in lung homogenate were ( 2. 32 ±0. 51) ×106 / g, ( 35. 7 ±9. 8) % , and ( 14. 5 ±5. 7) ng/L in the control group respectively, while increased in the smoker group [ ( 4. 57 ±0. 87) ×106 / g, ( 52. 5 ±10. 9) % , and ( 78. 3 ±13. 1) ng/L, P lt;0. 05] , and further increased in the COPD group [ ( 6. 61 ±1. 03) ×106 / g, ( 65. 5 ±12. 3) % , and ( 127. 0 ±35. 0) ng/L, P lt; 0. 05] . The lymphocytes proportion and BD-2 concentration in sputum increased in the COPD group [ ( 3. 2 ±1. 7) % and ( 298. 0 ±135. 0) ng/L] as well as in the smoker group [ ( 2. 5 ±1. 2) % and ( 315. 0 ±124. 0) ng/L] ,as compared with the control group [ ( 1. 1 ±0. 3) % and ( 132. 0 ±48. 0) ng/L] ( P lt; 0. 05) . Linear correlation analysis revealed that BD-2 concentration in sputumwas positively correlated with smoking index,sputum total cell count and neutrophils proportion, whereas BD-2 concentration in lung homogenate wasreversely correlated with pulmonary ventilation function ( P lt; 0. 05) . Conclusions Smoking up-regulates the BD-2 level in sputum and lung tissues. Further more, the BD-2 expression status in lung tissue of smoking individuals might be associated with COPD susceptibility.
Objective To explore the ultrastructure characteristics of pulmonary arteries in smokers with normal lung function and with chronic obstructive pulmonary disease ( COPD) . Methods 33 patients who undertook surgery for peripheral lung cancer were collected. According to smoking history and pulmonary function, the patients were divided into three groups, ie. non-smokers with normal pulmonary function ( group A, n = 10) , smokers with normal pulmonary function ( group B, n = 13) , and smokers in stable phase of COPD ( group C, n = 10) . Normal lung tissues without cancer were sampled and observed under light and electric microscope. Results ①Compared with group A, the thickness of intimal layer of intra-acinar pulmonary muscular arteries of group B and C were significantly higher, the area of their lumenwas lower, and the proportion of their muscular arteries was higher( P lt; 0. 01) . ②Ultrastructure of small pulmonary arteries of group A showed that intimal layer was normal, so as to endothelial cells and smooth muscle cells. Collagen fiber was not increased. Ultrastructure observation of group B showed that endothelialcells were distorted, basal membrane was thick, and collagen fiber increased in vessels. Ultrastructure observation of group C showed that endothelial cells degenerated, vascular intima thickness increased, andsynthetic phenotype smooth muscle cells increased. ③ Smoking index was positively correlated with the proportion of muscular arteries and the proportion of intimal area( r =0. 464,0. 635, P lt;0. 05, respectively) ,and negatively correlated with the proportion of lumen area( r= - 0. 603, P lt;0. 05) . Conclusions Smokers with normal lung fuction and with COPD show the similar ultrastructural characterizations in endothelial cells, smooth muscle cells, and pulmonary arterial remodeling, which related closely to smoking.
Objective To study the correlation between smoking and obstructive sleep apnea (OSA). Methods A total of 454 patients from October 2015 to July 2021 were retrospectively collected for nocturnal polysomnography monitoring (no less than 7 hours). The patients were divided into an OSA group (n=405) and a control group (n=49, patients with primary snoring) according to the results of polysomnography monitoring. According to the apnea hypopnea index (AHI) and the lowest oxygen saturation during sleep, the severity of OSA was classified into a mild to moderate group (5 times/h ≤ AHI<30 times/h) and a severe group (AHI ≥30 times/h). The patients were inquired about their smoking history, then the patients diagnosed with OSA were further divided into a smoking group, a smoking cessation group, and a non-smoking group based on their smoking history. Results The smoking rate of the patients in the OSA group was higher than that in the control group (50.9% vs. 32.7%, P<0.05), while the smoking rate in the severe OSA group was higher than that in the mild to moderate group (55.7% vs. 39.8%, P<0.05). Smoking was positively correlated with AHI, cumulative percentages of time spent at oxygen saturation below 90% (Ts90%), and total apnea time (r value was 0.196, 0.197, 0.163, P<0.05), while negatively correlated with the lowest and average SpO2 during sleep (r value was –0.202, –0.214, P<0.05). The logistic regression analysis with severe OSA as the outcome variable showed that smoking (OR=1.781) and obesity (OR=1.930) were independent risk factors of severe OSA (P<0.05). The comparison between groups of the OSA patients with different smoking states showed that the proportion of severe OSA, AHI, Ts90%, and total apnea time (77.8%, 53.55 times/h, 18.35%, and 111.70 minutes, respectively) of the smoking group were higher than those of the non-smoking group (62.8%, 40.20 times/h, 8.40%, and 76.20 minutes, respectively, P<0.05). The lowest SpO2 and average SpO2 during sleep (69.50%, 93.00%, respectively) of the smoking group were lower than those of the non-smoking group (75.00%, 94.00%, respectively, both P<0.05). The average SpO2 of the smoking cessation group was higher than that of the smoking group (94.00% vs. 93.00%, P<0.05), and the Ts90% of the smoking cessation group was lower than that of the smoking group (6.75% vs. 18.35%, P<0.05). Conclusions Smoking significantly affects the degree of sleep-disordered breathing and may be an independent risk factor for severe OSA. Smoking can exacerbate the severity of OSA and the degree of hypoxia, while smoking cessation can improve the degree of hypoxia in OSA patients.
